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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. MISSING
Regular Panel Decision

Love v. American Olean Tile Co.

In this workers' compensation action, employee Patricia Love appealed a judgment awarding her permanent total disability benefits to age 65 or until a maximum total benefit, with apportionment between the employer, American Olean Tile Company/Liberty Mutual Insurance Company, and the Second Injury Fund. The Special Workers’ Compensation Appeals Panel affirmed the trial court. The Supreme Court granted review to address the applicability of the maximum total benefit cap to age 65 awards and the correctness of the apportionment. The Court reversed the lower courts' decision to apply the maximum total benefit, ruling that permanent total disability benefits are payable to age 65 without monetary cap. It affirmed the apportionment, holding the employer responsible for 32.5% and the Second Injury Fund for 67.5% under Tenn.Code Ann. § 50-6-208(a).

Permanent Total DisabilityWorkers' CompensationSecond Injury FundBenefit ApportionmentMaximum Benefit CapAge 65 BenefitsCarpal Tunnel SyndromeLow Back StrainPre-existing DisabilityAppellate Review
References
1
Case No. No. 13
Regular Panel Decision

Fagg v. Hutch Manufacturing Co.

This workers' compensation case involved an appeal by Hutch Manufacturing Company and its insurance carrier concerning an employee, Mrs. Fagg, who sustained a compensable injury. The appeal raised issues regarding the duration of temporary total disability (TTD) benefits, the extent of permanent partial disability (PPD), a 6% penalty for unpaid installments, and medical expenses. The Court dismissed a preliminary appeal as interlocutory. It found the trial court erred in determining the termination date of TTD, concluding that Mrs. Fagg's TTD benefits should cease on October 9, 1984, the latest date for maximum medical recovery according to Dr. Coughlin's evaluations. The Court affirmed the trial court's award of 65% PPD to the body as a whole, emphasizing the consideration of non-medical factors in assessing disability. Furthermore, the Court upheld the 6% penalty on unpaid compensation installments due to the employer's demonstrated bad faith. The case was remanded for a more explicit allocation of medical expenses.

Temporary Total DisabilityPermanent Partial DisabilityMedical Impairment RatingJudicial ReviewRemandPenalty for Non-PaymentMedical EvidenceObjective SymptomsSubjective ComplaintsWorkers' Compensation Appeal
References
12
Case No. 2016-01-0218
Regular Panel Decision
Jun 06, 2016

Sanchez, Yonics v. Oz Construction Co.

Yonics Alexis Enriquez Sanchez, an undocumented worker, sought temporary total disability benefits for a left-knee injury sustained in November 2014 while working for Oz Construction Co. The Expedited Hearing, presided over by Judge Thomas Wyatt in Chattanooga, focused on his entitlement to benefits for the period between April 1, 2015, and December 15, 2015, following surgery by Dr. Benjamin S. Miller. The court awarded Mr. Sanchez temporary total disability benefits for the period from April 1, 2015, until May 19, 2015, based on medical records and testimony. However, his claim for the subsequent period until December 15, 2015, was denied due to discrepancies in work status information, resulting in a net award of $1,835.23.

Workers' CompensationTemporary Total DisabilityExpedited HearingKnee InjuryUndocumented WorkerMedical RecordsCredibility AssessmentCausal ConnectionDisability DurationOrthopedic Surgery
References
4
Case No. 2015-03-0233
Regular Panel Decision
Apr 29, 2016

Roark, Kristen v. Team Health

Kristin Roark, an audit clerk for Team Health, sustained a right eye injury on March 17, 2015. Team Health initially provided workers' compensation benefits but later terminated temporary total disability benefits on April 7, 2015, citing a return-to-work note. Ms. Roark disputed this termination, stating she never received certain return-to-work information. The court found that Ms. Roark established she was disabled from working due to a compensable injury and that a causal connection existed between the injury and her inability to work. Consequently, the Court granted her request for additional temporary total disability benefits.

Temporary Total Disability BenefitsExpedited HearingEye InjuryMedical Treatment DisputeReturn to Work StatusCausation of InjuryBenefit TerminationPhysician AuthorizationTennessee Workers' Compensation LawWorkers' Compensation Judge Decision
References
4
Case No. 2016-06-0910
Regular Panel Decision
Jul 24, 2018

Fegan, Mark v. CSI Medical, Inc.

The case involved Mark Fegan seeking temporary disability benefits from his employer, CSI Medical, Inc., and its carrier, Am Trust, following a back injury in October 2015. Initially, Dr. Sullivan declared Fegan at maximum medical improvement (MMI) in March 2016, leading to a cessation of benefits. However, Fegan later sought treatment from Dr. Ronald Lakatos in Ohio, who performed surgery in May 2017 and provided a medical opinion contradicting Dr. Sullivan's MMI assessment. Dr. Lakatos stated that Fegan was not at MMI as of March 2016 and remained disabled through May 2017. The Court weighed the medical opinions, giving more weight to Dr. Lakatos's in-depth analysis, and found that Mr. Fegan was likely to prevail in demonstrating his entitlement to temporary disability benefits for the period from April 1, 2016, through May 30, 2017. Consequently, the Court ordered CSI to pay lump-sum temporary total disability benefits totaling $19,389.52.

Temporary DisabilityMedical ImprovementSpinal InjurySurgeryMMI DisputeMedical EvidenceExpedited HearingBenefit DeterminationCausationDisability Duration
References
2
Case No. MISSING
Regular Panel Decision

Smith v. U.S. Pipe & Foundry Co.

This worker's compensation case examines two key issues: the employer's entitlement to an offset against scheduled member benefits for Social Security old age insurance, and the correct accrual date for permanent total disability benefits. The plaintiff, Paul D. Smith, suffered multiple work-related injuries while employed by U.S. Pipe & Foundry Company, resulting in permanent total disability. The trial court denied U.S. Pipe the Social Security offset for a scheduled member injury but allowed it for the Second Injury Fund's portion of the permanent total disability benefits. The trial court also ruled that permanent total disability benefits accrue from the date of maximum medical improvement. The Special Workers' Compensation Appeals Panel reversed these findings. However, the Supreme Court rejected the Appeals Panel's conclusions, affirming the trial court's judgment that the employer is not entitled to the Social Security offset for scheduled member injuries and that permanent total disability benefits begin accruing upon the attainment of maximum medical improvement.

Worker's CompensationScheduled Member BenefitsSocial Security OffsetPermanent Total DisabilityMaximum Medical ImprovementAccrual DateSecond Injury FundAppeals Panel ReversalTrial Court AffirmationDisability Benefits
References
17
Case No. 2016-08-0678
Regular Panel Decision
Nov 04, 2016

Booze, Barbara v. Memphis Area Transit Authority

Ms. Barbara Booze, a sixty-year-old bus driver, suffered a work-related mental injury in September 2015 after witnessing a shooting. She received temporary total disability benefits from September 2, 2015, through May 3, 2016. Ms. Booze filed a Request for Expedited Hearing, seeking temporary disability benefits from May 3 to September 8, 2016, when she reached maximum medical improvement (MMI). The employer, Memphis Area Transit Authority (MATA), offered a light duty reservationist position, but Ms. Booze declined due to her anxiety related to buses. The Workers' Compensation Judge denied her claim, finding she did not provide sufficient medical proof of total disability or light duty restrictions to support entitlement to temporary partial disability benefits for the requested period.

Workers' CompensationTemporary Disability BenefitsPost-traumatic Stress DisorderPsychological InjuryMaximum Medical ImprovementReturn to WorkLight DutyExpedited HearingMedical EvidenceEmployer Accommodation
References
3
Case No. MISSING
Regular Panel Decision

Claim of Kowalchyk v. Wade Lupe Construction Co.

The claimant, a carpenter over 60 with an 11th-grade education, fractured his back and wrist in August 1985 while on a construction jobsite. Initially, his physician, Dr. James Slavin, considered him totally disabled, and he received total disability benefits from his employer's carrier. However, in December 1985, the employer reduced benefits to a partial disability rate, relying on a report from their consultant, Dr. Edward Pasquarella. The claimant subsequently filed for compensation, leading to a determination by the Workers’ Compensation Law Judge and ultimately the Workers’ Compensation Board that he had a total industrial disability. The employer appealed this decision, arguing it lacked substantial evidence. The court affirmed the Board's decision, considering the claimant’s physical limitations, age, work experience, and limited education, concluding he had no marketable skills outside carpentry.

Workers' CompensationTotal Industrial DisabilityPartial DisabilityMedical Testimony ConflictEarning Capacity AssessmentAppellate ReviewVocational RehabilitationAge & Education FactorsCarpenter InjuryScaffold Accident
References
3
Case No. MISSING
Regular Panel Decision
Jun 16, 2006

Fortis Benefits v. Cantu

Vanessa Cantu suffered severe injuries in a car accident and sued multiple parties. Her medical insurer, Fortis Benefits, intervened, seeking subrogation for medical benefits paid under the policy. After Cantu settled with the defendants, Fortis pursued recovery from Cantu. Cantu argued that the equitable "made whole" doctrine barred Fortis's claim because her total losses exceeded the settlement amount plus the benefits Fortis paid. The trial court and court of appeals sided with Cantu. The Texas Supreme Court reversed, holding that the "made whole" doctrine does not override an insurer's clear contractual subrogation rights. The Court affirmed the dismissal of Fortis's claims against Ford due to a pretrial agreement.

Insurance SubrogationMade Whole DoctrineContractual SubrogationEquitable SubrogationERISATexas LawInsurance Policy InterpretationPersonal InjuryAutomobile AccidentSettlement Proceeds
References
28
Case No. 2018-03-0420
Regular Panel Decision
Mar 06, 2019

Blevins, Keith v. 2Morrow's Total Home Maintenance

This case involves Keith Adam Blevins, an employee, against Jason Aaron Morrow dba 2Morrow’s Total Home Maintenance, an uninsured employer, for a left ankle injury sustained on December 14, 2017. The employer asserted an intoxication and drug use defense. The Court found that Mr. Blevins met his burden, ruling there was no medical evidence that his hydrocodone use proximately caused the injury. The Court ordered Mr. Morrow to pay Mr. Blevins' past medical expenses totaling $46,253.02, provide ongoing medical treatment with Dr. Pesut, and pay temporary total disability benefits for twenty-seven weeks and four days at $135.20 per week, totaling $3,727.64.

Workers' CompensationAnkle FractureIntoxication DefenseDrug Use DefenseTemporary Total DisabilityMedical ExpensesAverage Weekly WageUninsured EmployerExpedited HearingProximate Cause
References
7
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